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Nur 333 Fun 2 > Urinary Elimination (Exam 2) > Flashcards

Urinary Elimination (Exam 2) Flashcards

1
Q

TERMS TO KNOW

A
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2
Q

Micturition

A

-Complex process involving bladder, urinary spinchters, and CNS

-Voiding

-Impulses from the brain respond or ignore the urge

-When brain responds to urge: CNS send message and external sphincter relaxes and bladder empties

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3
Q

Voiding

A

Bladder contraction and urethral sphincter and pelvic floor muscles

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4
Q

Factors Influencing Urinary Elimination

A

-Growth and Development

-Sociocultural factors

-Psychological factors

-Personal habits

-Fluid intake

-Pathological condition

-Surgical procedures

-Diagnostic examinations

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5
Q

Changes in Older Adults: Increased

A

-Bladder irritability
-Bladder contractions during bladder filling
-Risk of urinary incontinence

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6
Q

Changes in older adults: Decreased

A

-Amount of nephrons
-Bladder muscle tone
-Bladder capacity
-Time between initial desire to void and urgent need to void

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7
Q

Urinary Retention

A

-Inability to partially or completely empty the bladder

-Pressure, discomfort, pain

-Can be acute or chronic

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8
Q

How to diagnoses Urinary Retention

A

-Diagnose with Post-Void Residual (PVR)

-Bladder scanner or straight cath

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9
Q

Urinary Tract Infections

A

-Most common type is E-coli

Anywhere along urinary tract. Upper = kidneys. Lower=bladder

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10
Q

Bacteriuria

A

-Bacteria in the urine

-Does not mean UTI. Can be indicator though

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11
Q

UTI: Risk factors

A

-Presence of indwelling catheter

-Any instrumentation of urinary tract

-Urinary retention

-Fecal incontinence

-Poor hygiene

-Female

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12
Q

Review Upper vs Lower Symptoms of UTI

A
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13
Q

CAUTI

A

-Major Risk of development with presence of indwelling catheter and length of use

-Costly—no reimbursement

-Can be reasonably prevented

-Focus on early recognition and prompt treatment

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14
Q

Urinary Incontinence

A

Involuntary loss of urine

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15
Q

Forms of Urinary Incontinence

A

Urgency-Stress-Overflow

Often multifactorial

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16
Q

Urinary Incontinence: Overflow

A

-Poor bladder emptying or bladder obstruction

-Males with BPH

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17
Q

Urinary incontinence: Stress

A

-Exertion: Laughing, coughing, sneezing

-Usually women after childbirth

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18
Q

Urinary Incontinence: Urgenecy

A

-Overactive bladder

-Idopathic

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19
Q

Urinary Incontinence: Functional

A

Just not being able to get to the bathroom

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20
Q

Incontinecne Risk Factors

A

-More common in women and elderly

-Obesity

-Multiple pregnancies

-Neurological disorders

-Medications

-Confusion

-Dementia

-Immobility

-Depression

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21
Q

Assessment of Urinary Issues

A

-Assess understand expectations of treatment

-Be professional

-Assess ability to prefrom necessary behaviors

-Assess for any culture or personal considerations

-past medical history

-Medication use

-Normal Bowl and urinary elimination patterns

-Sleep, activity and nutrition

22
Q

Assessment: Nursing History

A

Pattern of Urination:
-Frequency
-Amount
-History of changes

Symptoms:
-Urgency
-Dysuria
-Frequency
-Hesitancy
-Polyuria
-Oliguria
-Nocturia
-Dirbbling
-Hematuria
-Retention

23
Q

Assessing for CVA tenderness

A

-Costovertebral Angle

-Testing for Kidney infection

24
Q

Assessment of urine

A

-Intake and Output

-Characteristics of urine

25
Q

Normal Urine Output

A

> 30 mls/hr

26
Q

Concerned about output

A

-If output is <30 mls/hr for 2 hours

-If patient is awake and has gone 6 hours without voiding

27
Q

Urinary Chart

A

Screen shot

28
Q

Measurement of Urine: Catheter

A

-Foley bad with UROMETER

-Most accurate way

29
Q

Measurement of Urine

A

Urinal

Female Urinal

30
Q

Urine Testing

A

-Know to collect the urine

-Label appropriately per hospital protocol

-Send as soon as you receive unless it is a timed test

-Know if you need a preservative or not

31
Q

Urinalysis: Nursing Considerations

A

-Must be fresh

-Collect urine normal voiding, indwelling catheter, or urinary diversion

-Must have freshly voided urine

-Cannot take urine from catheter bag

32
Q

Urinalysis Normal Values

A

Bacteria Negative
Leukocyte Negative
WBC 0-4

33
Q

Culture and Sensitivity

A

-Can obtain from clean void or clean catch mid stream urine specimen

-Send to lap within 30 min

-Preliminary report should be available within 234 hours

-Use STERILE cup

34
Q

Sample of Urine Culture Results

A
35
Q

Abdominal Xray: KUB

A

-Determines size, shape, symmetry, location of structures of the urinary tract

-Common uses: (urinary calculi (kidney stone)

-No special Preparation

36
Q

Nursing Problems Urinary Elimination

A

Impaired Urinary Elimination

Urinary Retention

Incontinence

Impaired Comfort or Pain

Risk for infection (Folly)

37
Q

Health Promotion and Patient Education

A

-Promote self-care practice

-Maintain normal routine

-Promote healthy nutrition

-Strengthen pelvic floor muscles

-Be vigilant about prostate health

-Report any changes in urinary tract

38
Q

Maintaining Adequate Fluid Intake

A

-2300 mls/day if renal function is ok, no heart disease and no need for fluid restriction

-Helps flush solutes to limit bladder irritability

39
Q

If fluid intake needs increased:

A

-Schedule time to drink
-Fluid Preferences
-High fluid foods (fruits)
-Stop drinking about 2 hours before bedtime to prevent nocturia

40
Q

Nurinary Retention: Nursing Care

A

-Assess and monitor urine output

-Assess for bladder distention

-Run water and flush commode

-Help train bladder to empty fully

-Try around the clock voiding

-Intermittent catheterization

41
Q

Preventing Infection

A

-Follow Protocol

-Asses for infection

-Preform perineal hygeine

-Void at regular intervals

-Adequate fluid intake

-Female consideration

42
Q

Incontinence Care

A

-Be respectful of patient feelings

-Pelvic floor muscle training

-Lifestyle changes

-Bladder retraining

-Toileting schedule

-Meticulous skin care

42
Q

Meticulous Skin Care: Do’s

A

-Identify and treat
-use skin risk assessment tool
-Use appropriate skin barrier products
-Ensure adequate hydration
-Consult WOCN if needed

43
Q

Meticulous Skin Care: Don’ts

A

-Use traditional soap and water
-Double padding the bed
-Leve solied pads

44
Q

Types of Urethral Cathetes

A

Single Lumen (No balloon)

Indwelling catheter (Temp sensing)

3 way / 3 lumen (Bladder irrigation)

Coude tip (Curved rounded) (enlarged prostate)

45
Q

Other types of Catheters: Suprapubic

A

Placed in the bladder through abdominal wall. (Sutured in place) (Used when blockage of urethra or when indwelling catheter causes irritation)

46
Q

Purewick

A

Sits in-between female patient legs and is hooked to genital suction

They are not dry

47
Q

Condom Cath

A

Is what it is

Decrease risk of infection

Not fool proof

48
Q

Nursing Care: Catheter Care

A

-Regular Perineal care (Peri-Care)

-Provide catheter care or baths per hospital protocol

-Secure catheter to prevent pulling or movement

-Empty drainage bags when it is 1/2 full

-Do not allow the bag to touch the floor

-Maintain a closed drainage system

-Timely removing

49
Q

Before Catheter Insertion and While Indwelling

A

Peri-Care (Front to back) (Do not spread E-coli)

Males: Uncircumcised

-Can be delegated to nursing assistant or patients

-CHG wipes with bath and Castile wipes Q12 prn

50
Q

UK healthcare Nurse Driven Protocol Removal of Urinary Catheter

A

-Follow algorithm

51
Q

Post-Catheter Removal

A

-At risk for urinary retention.

-If have not voided in 6 hours then assessing and bladder to scan to see if there is retention

-Greater than 400 preform in-out cathereization

Nur 333 Fun 2 (12 decks)

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